J Korean Surg Soc.  2009 Oct;77(4):250-256. 10.4174/jkss.2009.77.4.250.

Surgical Treatment of the Esophageal Diverticulum

• Ko SM
• Kim HI
• Kim CB

• KMID: 1464882
• DOI: http://doi.org/10.4174/jkss.2009.77.4.250

Abstract

PURPOSE
Clinical presentation and surgical results of the esophageal diverticula were analyzed. METHODS: Ten patients who underwent esophageal diverticulectomy with myotomy from May 1999 to May 2008 were reviewed retrospectively. RESULTS: Three pharyngoesophageal, one midesophageal and six epiphrenic diverticula were observed and transcervical, right transthoracic and left transthoracic surgical approach were used respectively. All of these cases were pulsion type and diverticulectomy with esophageal myotomy were done. For those who had leiomyoma, enucleation was performed simultaneously. One postoperative leakage was observed and resolved with conservative management. At 3 months after surgery, all patients enjoyed satisfactory results except two patients. One patient still suffered dysphagia which was not improved after surgery and the other patient had asymptomatic gastroesophageal reflux disease which was found on the follow up esophagography. CONCLUSION: Crucial factors in the treatment of esophageal diverticulum are high index of suspicion indicated by clinical symptoms, differential diagnosis with other disease and confirmatory diagnosis with esophagography. Diverticulectomy with esophageal myotomy is an essential procedure for the low recurrence of diverticulum.

Keyword

Esophagus; Diverticulum; Myotomy

MeSH Terms

Deglutition Disorders
Diagnosis, Differential
Diverticulum
Diverticulum, Esophageal
Esophagus
Follow-Up Studies
Gastroesophageal Reflux
Humans
Leiomyoma
Recurrence
Retrospective Studies

Figure

• 

  Fig. 1 Esophagographic finding of the esophageal diverticula. These preoperative esophagographies demonstrate (A) pharyngoesophageal, (B) midesophageal and (C) epiphrenic esophageal diverticula. A sac-like collection of esophagograffin can be seen.

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  Fig. 2 Esophagogastroduodenoscopic finding of the esophageal diverticula. These preoperative esophagogastroduodenoscopies demonstrate (A) pharyngoesophageal, (B) midesophageal and (C) epiphrenic esophageal diverticula. There are food materials in the diverticula.

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  Fig. 3 Esophagographic finding at 4th postoperative day. Postoperative esophagography confirms no leakage.

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